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On Tuesday, March 2, 2010, The Center for Global Development hosted a seminar on The Long Road to Universal Health Coverage: A century of lessons for development strategy featuring Jesse B. Bump, Takemi Fellow in International Health Policy, Harvard School of Public Health. Rachel Nugent, Deputy Director, Global Health, Center for Global Development, moderated the discussion.
Paper abstract: Health systems are among the most important elements of the social contract that defines modern nations. This paper investigates the historical origins of universal health care (UHC) systems and analyzes the politics surrounding the national decision to implement them. Understanding how, when, and why countries have established UHC systems sheds light on current international assistance strategies to encourage the same transition in developing countries. First, Dr. Bump analyzes definitions of UHC to distill the important elements and discuss their primary assumptions, including their commitments to solidarity, redistribution, and government responsibility. He then focuses on the development of the two main financing models--social health insurance (Germany) and general taxation (United Kingdom)--and then follows global-level attempts to promote UHC over the past century. Dr. Bump finds that international aid agencies have not played a significant role in fostering the spread of UHC systems in the past. Beyond the possibility of fostering international learning and providing resources, there is no clear evidence in support of any particular role for international actors in fostering UHC systems.